Occupational Therapy Review: Weeks 7 to 13

A complete set of 700 flashcards based on lecture notes covering oral health, nutrition, chronic conditions, pain, mistreatment, mental health, and end-of-life care.

What four major oral-health conditions should you know in older adults?

Periodontal disease, dental decay, oral cancer, and dry mouth/xerostomia.

What is gingivitis?

Inflammation of the gums characterized by redness and bleeding.

What is periodontitis?

More advanced periodontal disease that can cause bone loss and gingival recession.

What is gingival recession?

Recession of gum tissue that exposes more of the tooth/root.

Why does gingival recession increase dental-decay risk?

The exposed root surface becomes vulnerable to root caries.

What is plaque?

A dental biofilm containing living bacteria.

Approximately how quickly does plaque reform?

Every $12-24\,\text{hours}$.

What is calculus/tartar?

Calcified plaque.

What is a major strategy for controlling periodontal disease?

Regular mechanical plaque removal.

What are two primary methods of mechanical plaque removal?

Toothbrushing and interdental cleaning/flossing.

When should flossing ideally occur?

Once nightly before brushing.

What shape should floss form around a tooth?

A C-shape.

What motion is used during flossing?

Up-and-down movement along the tooth surface.

What can replace traditional floss when hand function is impaired?

Floss holders/picks, interdental brushes, electric flossers, or water flossers.

What toothbrush firmness is generally recommended?

Soft or extra-soft.

Why might an electric toothbrush benefit an older adult?

It decreases the hand/wrist movement required.

What can OT do if a toothbrush handle is difficult to grasp?

Build up/enlarge the handle or recommend an adapted/electric toothbrush.

What is the basic denture-care sequence?

Brush \rightarrow rinse \rightarrow soak overnight.

True or False: Denture users no longer require oral hygiene.

False.

Why do denture users still need oral hygiene?

Dentures and oral tissues still require cleaning and monitoring.

What three major strategies help prevent dental decay?

Fluoride, limiting sugary snacks, and plaque removal.

What concentration of NaF mouthrinse was discussed?

$0.05\%$.

How long should the person rinse with the NaF mouthrinse?

Approximately $1\,\text{minute}$.

How long should eating/drinking be avoided afterward?

Approximately $30\,\text{minutes}$.

Why is alcohol-free mouthrinse important with xerostomia?

Alcohol can worsen oral dryness.

What is xerostomia?

Dry mouth.

What can cause xerostomia?

Medications, smoking, alcohol, radiation, chemotherapy, mouth breathing, and other factors.

What simple strategy can help xerostomia?

Frequent sips of water.

What type of gum can help xerostomia?

Sugar-free gum.

What environmental intervention can help dry mouth?

Using a humidifier.

Why should caffeine sometimes be limited with xerostomia?

It may contribute to dryness.

What is an oral-cancer warning sign?

A persistent mouth sore or unexplained red/white lesion.

What other findings can indicate oral cancer?

Mouth pain, bleeding sore, neck lump, or sensation of something caught in the throat.

What is halitosis?

Bad breath.

What three characteristics of sugar consumption matter for oral health?

Type, form, and timing/frequency.

What are the three macronutrients?

Carbohydrates, protein, and fat.

Approximately what percentage of calories should come from carbohydrates in the lecture?

$50-60\%$.

Approximately what percentage should come from protein?

$15-20\%$.

Approximately what percentage should come from fat?

$30\%$.

What typically happens to muscle mass with aging?

It decreases.

What typically happens to abdominal/visceral fat with aging?

It increases.

What is anorexia of aging?

Age-associated decreased appetite/intake that can contribute to inability to maintain normal body weight.

What can unintended weight loss cause?

Reduced bone density, muscle loss, poor activity tolerance, falls, frailty, and functional decline.

Why does dehydration risk increase with age?

Recognition of thirst may decrease.

Approximately how much fluid was discussed for normal hydration?

About $6-7$ eight-ounce glasses, depending on individual needs.

What is a 24-hour dietary recall?

Recalling everything eaten and drunk during the previous $24\,\text{hours}$.

What does MST stand for?

Malnutrition Screening Tool.

What does the MST primarily examine?

Unintentional weight loss and appetite.

What does MUST stand for?

Malnutrition Universal Screening Tool.

What does MUST consider?

BMI, weight loss, and effects of acute illness.

What does MNA-SF stand for?

Mini Nutritional Assessment–Short Form.

What population is the MNA-SF particularly designed for?

Older adults.

What does the D in DETERMINE represent?

Disease.

What does the first E in DETERMINE represent?

Eating poorly.

What does T represent?

Tooth loss/mouth pain.

What does the second E represent?

Economic hardship.

What does R represent?

Reduced social contact.

What does M represent?

Multiple medicines.

What does I represent?

Involuntary weight loss/gain.

What does N represent?

Needs assistance in self-care.

What does the final E represent?

Elder years above age $80$.

Why is DETERMINE clinically useful?

It identifies warning signs associated with nutritional risk.

What is dysphagia?

Difficulty with eating/swallowing.

What is aspiration?

Entry of foreign material into the airway/lungs.

What is silent aspiration?

Aspiration without obvious coughing or choking.

Why is silent aspiration dangerous?

It can occur without obvious warning signs.

What is pocketing?

Food remaining between the teeth and cheek.

What can pocketing indicate?

Difficulty adequately managing food in the mouth.

What is the least viscous liquid consistency?

Thin.

What comes after thin in the course sequence?

Nectar-like.

What comes after nectar-like?

Honey-like.

What is the thickest consistency in the sequence?

Spoon-thick.

Put the consistencies in order.

Thin \rightarrow nectar-like \rightarrow honey-like \rightarrow spoon-thick.

What should the hips generally be positioned at for self-feeding?

Approximately $90^{\circ}$.

What should the knees generally be positioned at?

Approximately $90^{\circ}$.

What should the feet generally be positioned at?

Supported at approximately $90^{\circ}$.

How should weight be distributed during feeding?

Evenly.

How should the head generally be positioned?

Upright and slightly forward.

Approximately how far should the mouth be from the plate?

$10-15\,\text{inches}$.

Why does positioning matter during feeding?

It supports safe, efficient feeding and swallowing.

What adaptive device can assist someone with absent grip?

Universal cuff.

What does a universal cuff do?

Holds a utensil or other object without requiring normal grasp.

What utensil modification can help limited grip strength?

Built-up handles.

Why are built-up handles useful?

They reduce the amount of hand closure/grip required.

What should OT assess before recommending feeding equipment?

The specific reason feeding is difficult.

A client has normal swallowing but cannot grip a fork. What should OT target?

The motor/grasp barrier rather than swallowing.

A client repeatedly pockets food. Is simply providing a built-up spoon sufficient?

No; the swallowing/oral-management issue must be recognized.

Why should OT distinguish feeding from swallowing problems?

The appropriate intervention depends on the underlying cause.

A client cannot manipulate floss because of arthritis. What is an appropriate OT approach?

Adapt the task/tool rather than simply telling the person to floss harder.

What general OT principle connects oral care and feeding?

Analyze the task demands and match adaptations to the person's functional barriers.

An older adult has bleeding, red gums. What condition should you suspect?

Gingivitis.

An older adult has gum recession and bone loss. What condition is more likely?

Periodontitis.

A client takes several medications and constantly reports dry mouth. What should you consider?

Medication-associated xerostomia.

A client coughs during meals. What issue requires attention?

Possible swallowing/aspiration difficulty.

A client aspirates but does not cough. What is this called?

Silent aspiration.

Food remains between a client's cheek and teeth after eating. What is this called?

Pocketing.

A client with severe hand weakness cannot hold a spoon. What device is high-yield?

Universal cuff.

An older adult has unexplained weight loss and reduced appetite. What type of issue should be screened?

Nutritional risk/malnutrition.

What acronym should immediately make you think “nutrition risk factors”?

DETERMINE.

What is the Week 7 big-picture OT concept?

Support safe and independent participation in nutrition, feeding, swallowing-related routines, and oral hygiene by identifying the underlying functional barrier and adapting the person, activity, or environment.